多层螺旋CT对胃肠道间质瘤的良恶性诊断价值

Diagnostic value of multi-slice spiral CT in benign and malignant gastrointestinal stromal tumors

目的探讨多层螺旋CT扫描对胃肠道间质瘤的良恶性诊断价值。方法回顾分析48例经术后病理证实的GIST患者的临床及多层螺旋CT扫描资料。结果 48例胃肠道间质瘤(GIST)中,良性12例,潜在恶性13例,恶性23例。肿瘤直径<5 cm组19例,恶性3例,肿瘤直径≥5 cm组29例,恶性20例;有囊变坏死或溃疡改变31例,其中恶性22例,无囊变坏死共17例,其中恶性1例;14例有转移改变者病理均为恶性。样本中肿瘤大小≥5 cm组恶性程度较高,且肿瘤体积越大,恶性程度亦相对越高,呈一定的正相关改变,合并有囊变坏死、溃疡或转移者,其恶性程度亦显著增高(P<0.05)。结论多层螺旋CT对GIST的定位、定性诊断有重要价值,多种CT征象有助于对GIST良、恶性做出准确判断。

Objective To investigate the value of multi-slice spiral CT in the diagnosis of benign and malignant gastrointestinal stromal tumors （GIST）. Methods The clinical and multi-slice spiral CT data of 48 patients pathologically confirmed as GIST were retrospectively analyzed. Results Among the 48 patients, 12 were diagnosed as benign, 13 were potentially malignant, and 23 were malignant. There were 19 cases with rumor diameter 〈5 cm, of which 3 cases were malignant. There were 29 cases with tumor diameter ≥ 5 cm, of which 20 cases were malignant. There were 22 cases of malignant among the 31 cases of cystic necrosis or ulceration, and among the 17 cases without cystic necrosis there was 1 case of malignant. The 14 cases of metastasis with pathological changes were all malignant. In patients with tumor size ≥5 cm, degree of malignancy was higher, and the degree of malignancy got higher as the tumor volume got larger, showing a positive correlation. The degree of malignancy was significantly higher in patients complicated with cystic necrosis, ulceration, or metastasis （P〈0.05）. Conclusion Multi-slice spiral CT has significant value in the location and qualitative diagnosis of GIST, and multiple CT findings contribute to diagnosing the benign and malignant nature of GIST.